colestipol

Absorption: Action takes place in the GI tract. No absorption occurs.

Distribution: No distribution.

Metabolism/Excretion: After binding bile acids, insoluble complex is eliminated in the feces.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

(hypocholesterolemic effects)

ROUTE	ONSET	PEAK	DURATION
PO	24–48 hr	1 mo	1 mo

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity;
Complete biliary obstruction;
Some products contain aspartame and should be avoided in patients with phenylketonuria.

Use Cautiously in:

History of constipation.

Pedi: May cause potentially fatal intestinal obstruction in children.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: irritation, rash

EENT: irritation of the tongue

F and E: hyperchloremic acidosis

GI: abdominal discomfort, constipation, nausea, fecal impaction, flatulence, hemorrhoids, perianal irritation, steatorrhea, vomiting

Metab: vitamin A, D, and K deficiency

Interactions ⬆ ⬇

Drug-drug:

May ↓ absorption/effects of orally administered acetaminophen, amiodarone, clindamycin, digoxin, diuretics, gemfibrozil, glipizide, corticosteroids, imipramine, mycophenolate, methotrexate, niacin, NSAIDs, penicillin, phenytoin, propranolol, tetracyclines, thyroid preparations, ursodiol, warfarin, and fat-soluble vitamins (A, D, E, and K).
May ↓ absorption of other orally administered medications.

Route/Dosage ⬆ ⬇

PO (Adults ): Granules: 5 g 1–2 times daily; may be ↑ every 1–2 mo up to 30 g/day in 1–2 doses. Tablets: 2 g 1–2 times daily, may be ↑ every 1–2 mo up to 16 g/day in 1–2 doses.

Availability ⬆ ⬇

(Generic available)

Granules for suspensionunflavored [with aspartame]: 5 g/packet or scoop
Tablets: 1 g

Assessment ⬆ ⬇

Hypercholesterolemia: Obtain a diet history, especially regarding fat consumption.
Pruritus: Assess severity of itching and skin integrity. Dose may be decreased when relief of pruritus occurs.
Diarrhea: Assess frequency, amount, and consistency of stools.
Assess for signs and symptoms of fecal impaction or obstruction (abdominal pain and tenderness, abdominal distention, severe constipation, watery diarrhea, nausea, and vomiting).

Lab Test Considerations:

Serum cholesterol and triglyceride levels should be evaluated before initiating, frequently during first few mo and periodically throughout therapy. Discontinue medication if paradoxical increase in cholesterol level occurs.
- May cause an increase in AST, ALT, phosphorus, chloride, and alkaline phosphatase and a decrease in serum calcium, sodium, and potassium levels.
- May also cause prolonged PT.

Implementation ⬆ ⬇

Parenteral or water-miscible forms of fat-soluble vitamins (A, D, E, K) and folic acid may be ordered for patients on chronic therapy.
PO: Administer before meals.
- DNC: Swallow tablets whole; do not crush, break, or chew.
- Scoops for powdered preparations may not be exchangeable between products.
- Administer other medications 1 hr before or 4–6 hr after the administration of this medication.

Patient/Family Teaching ⬆ ⬇

Explain reason for and side effects of colestipol to patient.
Instruct patient to take medication exactly as directed; do not skip doses or double up on missed doses. Supplementation of fat-soluble vitamins may be needed (A, D, E, K).
Instruct patient to take medication before meals. Tablets should be taken with a full glass of water to avoid esophageal obstruction. Granules can be mixed with water, juice, or carbonated beverages. Slowly stir in a large glass. Rinse glass with small amount of additional beverage to ensure all medication is taken. May also mix with highly fluid soups, cereals, or pulpy fruits (applesauce, crushed pineapple). Allow powder to sit on fluid and hydrate for 1–2 min before mixing. Do not take dry.
Advise patient that this medication should be used in conjunction with diet restrictions (fat, cholesterol, carbohydrates, alcohol), exercise, and cessation of smoking.
Explain that constipation may occur. Increase in fluids and bulk in diet, exercise, stool softeners, and laxatives may be required to minimize the constipating effects. Instruct patient to notify health care professional if severe constipation, abdominal pain, bloating, cramps, nausea, vomiting, flatulence, and heartburn persist or if stools become frothy and foul smelling.
Advise patient to notify health care professional if unusual bleeding or bruising; petechiae; or black, tarry stools occur. Treatment with vitamin K may be necessary.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇